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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Steve2 on July 30, 2000, at 16:45:04
Does this sound familiar to anyone: Whenever I'm on an SSRI or Effexor I have problems with extreme sweating. I'm not talking about a liitle persperation -- I'm taking streams of sweat and a general intolerance to the heat. I've gone to my doctor (and specialists), had ever test under the sun, have tried adding anti-hypertensives, etc. all to no avail. Then recently I heard that people who use Ecastcy (which works on Seretonin [sorry about the spelling]) often die from overheating. So, does Seretonin cause elivated body temp? How?
Posted by danf on July 30, 2000, at 19:19:02
In reply to extreme sweating when on SSRI's, posted by Steve2 on July 30, 2000, at 16:45:04
which anti-hypertensives ?
body metabolism is speeded up by adrenaline. seratonin can cause an increase in adrenaline release. Increased metabolic rate causes increased temps.
I had the same with zoloft.
Inderal & now pindolol have gotten rid of the increased sweating & even better the heat intolerance. I could deal with the dripping but the heat intol was miserable.
The effective dose has been 30mg /day for pindolol. took about 30 days to fully work. I sweat even less than some "normal" folks. on occasion tho, still get a wierdy or 2.
Yesterday it was 90degF & was sitting out. sneezed a couple of times & eyes watered & nose dripped for about 2 min. then my Left arm pit dripped for about 15 min. no sweat elsewhere.
some of these effects are whaco !
Posted by shar on July 30, 2000, at 19:27:50
In reply to extreme sweating when on SSRI's, posted by Steve2 on July 30, 2000, at 16:45:04
Interesting! I am an Effexor sweater, and I live in Texas, so I have lots of opportunities to experience it.
I was reading Psychobabble Tips last night and they have a segment on sweating. Especially around head and neck. (That's where mine is; it is so professional to have sweat streaming down your neck and dripping off your ears!)
So, the docs in Tips were talking about various agents (prescription meds) that help stop the excessive sweating. There are a variety of them that appear to work pretty well. I am really tempted to try one, but the idea of getting on yet another med is too much for me right now.
I wonder if I could just use a roll-on anti-perspirant on my neck (seriously, I've considered it!). My sweating will start if my shower is too warm, so I'm dripping the whole time I'm getting dressed (ick); it takes sitting down (still) for at least half an hour in a cool place before it will stop. And I usually drink water also if I'm trying to cool down.
I don't believe Tips had anything on what was causing it, just went right in to the discussion.
Shar
Posted by Steve2 on July 30, 2000, at 21:01:22
In reply to I'm one Big Effexor Sweat Ball » Steve2, posted by shar on July 30, 2000, at 19:27:50
I've tried the antipersperant over the body trick and it doesn't help. I've also tried prescription Drysol. In fact, I've even had the surgical procedure ETS and it helped great with the face and underarms. But my back and chest are still swamps!
Posted by Sunnely on July 30, 2000, at 21:36:16
In reply to extreme sweating when on SSRI's, posted by Steve2 on July 30, 2000, at 16:45:04
>Then recently I heard that people who use Ecastcy (which works on Seretonin [sorry about the spelling]) often die from overheating. So, does Seretonin cause elivated body temp? How?
This is a theoretical possibility. FYI, serotonin is a neuromodulator of dopamine (i.e., increased serotonin effect decreases dopamine action). Body temperature is controlled in the hypothalamus by regulation of various factors. Dopamine exerts some influence on the temperature-regulating function of the hypothalamus. If dopamine action is hampered, this thermoregulatory function of the hypothalamus could be disturbed and usually assumes the ambient temperature. In addition, once body temperature begins to rise, there is an increase in cellular metabolism (13% for every degree centigrade rise in core temperature). These factors can lead to a vicious cycle of ever increasing body temperature, heatstroke, and finally death. However, generally no serious complications occur if the ambient temperature remains within "acceptable" level or the person stays within an acceptable level of ambient temperature (e.g., air-conditioned place).On the other hand, if the ambient temperature is high (e.g., high environmental temperature with high humidity), blocking the action of dopamine can interfere with the ability of the hypothalamus to maintain a stable body temperature which subsequently follows the ambient temperature leading to potentially serious elevation of body temperature (e.g., heatstroke). People on antipsychotics (dopamine receptor blocking effect) and antidepressants (older ones, via anticholinergic effect and, newer ones via serotonergic effect and anticholinergic effect as in Paxil) are at high risk for developing serious elevations of body temperature during high environental temperature and humidity (especially during heat wave). Of course, an effective way to avoid this potentially serious medical problem is to stay in an air-conditioned area during this type of weather.
Another potentially serious complication of serotonin in excess is the condition called "serotonin syndrome." This condition usually occurs in combination of drugs that have serotonin-boosting effects. However, it has also been reported in monotherapy (single drug) with the SSRIs and yes, with "ecstasy." Elevated body temperature and sweating usually occur in this condition but not enough to arrive at a conclusive diagnosis. If fever and sweating are the only symptoms present, you probably do not have "serotonin syndrome." Other symptoms should be present especially muscle twitchings/jerking (myoclonus) and hyperreflexia (overactive reflexes). Chills (teeth-chattering), confusion, agitation, restlessness, tremor, diarrhea may also be present. Deaths from "serotonin syndrome" have been reported. Note that the syndrome caused by "ecstasy" intoxication produces a clinical picture that overlap between serotonin syndrome and neuroleptic malignant syndrome (NMS). The following signs and symptoms have been reported in cases of "ecstasy" intoxication: confusion, agitation, elevated body temperature, muscle rigidity, rapid heart rate, elevated or low blood pressure, sweating, hypperreflexia, myoclonus, sweating, diarrhea, and elevated CPK or CK (muscle enzymes). Deaths may occur from acute kidney failure.
Drug combinations reported to cause or with potential for serotonin syndrome include:
1] monoamine oxidase inhibitors (MAOIs) + SSRIs and other serotnin-boosting drugs such as Serzone, Effexor, Remeron, tryptophan.
2] MAOI + meperidine (Demerol)
3] MAOI + dextromethorphan (e.g., Robitussin DM)
4] tryptophan + SSRIs
5] Trazodone + SSRIs
6] Sumatriptan (Imitrex) + SSRI
7] Tramadol (Ultram) + SSRI
8] St. John's wort + SSRI
Posted by shar on July 30, 2000, at 22:58:38
In reply to Re: I'm one Big Effexor Sweat Ball, posted by Steve2 on July 30, 2000, at 21:01:22
Wow, you have explored the options! I will abandon hope for the anti-perspirant trick.
What is the ETS procedure? I've never heard of it before.
Shar
> I've tried the antipersperant over the body trick and it doesn't help. I've also tried prescription Drysol. In fact, I've even had the surgical procedure ETS and it helped great with the face and underarms. But my back and chest are still swamps!
Posted by Cindy W on July 31, 2000, at 0:17:16
In reply to I'm one Big Effexor Sweat Ball » Steve2, posted by shar on July 30, 2000, at 19:27:50
> Interesting! I am an Effexor sweater, and I live in Texas, so I have lots of opportunities to experience it.
>
> I was reading Psychobabble Tips last night and they have a segment on sweating. Especially around head and neck. (That's where mine is; it is so professional to have sweat streaming down your neck and dripping off your ears!)
>
> So, the docs in Tips were talking about various agents (prescription meds) that help stop the excessive sweating. There are a variety of them that appear to work pretty well. I am really tempted to try one, but the idea of getting on yet another med is too much for me right now.
>
> I wonder if I could just use a roll-on anti-perspirant on my neck (seriously, I've considered it!). My sweating will start if my shower is too warm, so I'm dripping the whole time I'm getting dressed (ick); it takes sitting down (still) for at least half an hour in a cool place before it will stop. And I usually drink water also if I'm trying to cool down.
>
> I don't believe Tips had anything on what was causing it, just went right in to the discussion.
>
> Shar
Steve2, I sweat from Effexor-XR too (but usually at night); the daytime feeling of being "hot" and sweaty disappeared after a few weeks. BTW, I should have said "perspire" instead of "sweat" (females don't sweat, they perspire! I forgot!) ;)
Posted by Steve2 on July 31, 2000, at 14:17:29
In reply to Steve2: What is ETS?, posted by shar on July 30, 2000, at 22:58:38
ETS= Endoscopic Transthoracic Sympathicotomy, which is a procedure whereby a surgeon severes some of the sympathetic nerves that control sweating. If you search under the medical term for excessive sweating, hyperhydrosis, in the internet you can get all kinds of info on it. The upsot is thus: it is very expensive and not covered by insurance but does help hand and facial sweating. For me, in my occupation, that was a great help, but I still suffer from tremendous sweating around the trunk and back.
>
>
> > I've tried the antipersperant over the body trick and it doesn't help. I've also tried prescription Drysol. In fact, I've even had the surgical procedure ETS and it helped great with the face and underarms. But my back and chest are still swamps!
Posted by Sunnely on July 31, 2000, at 19:28:49
In reply to extreme sweating when on SSRI's, posted by Steve2 on July 30, 2000, at 16:45:04
> Does this sound familiar to anyone: Whenever I'm on an SSRI or Effexor I have problems with extreme sweating.
The exact cause of antidepressant-induced sweating is unknown. Unfortunately, sweating is a relatively common side effect seen with selective serotonin reuptake inhibitors (SSRIs) and has been reported in 7% to 11% of patients treated with SSRIs and 12% of patients treated with Effexor, an antidepressant with the ability to inhibit the reuptake of serotonin and norepinephrine.The following is an anecdotal report of Effexor-induced sweating successfully treated with benztropine (Cogentin), an anticholinergic. This was the case of 48-year-old school teacher with depression who was nonresponsive to Prozac, Zoloft, and psychotherapy. She was treated with Effexor 75 mg three times daily with complete remission of her depression, but experienced severe and socially embarrassing sweating that she was compelled to stop the drug. She agreed to restart Effexor at 75 mg 2 times daily with benztropine added at 0.5 mg twice daily. Effexor was then increased to 75 mg 3 times daily with subsequent remission of her depression and no sweating.
The authors suggested that presumably, SSRIs (and Effexor) enhance sweating either indirectly by affecting the sympathetic system or directly by acting on the hypothalamus. In this case, they believed that benztropine most likely blocked the acetylcholine receptors on the eccrine sweat glands and thereby caused a reduction in sweating. They proposed a more detailed explanation of this effect as follows: The eccrine sweat glands are stimulated by the sympathetic nervous system; however, the postganglionic fibers that reach the muscarinic receptors on the end organ are cholinergic. The preoptic and anterior hypothalamic nuclei are the areas of the hypothalamus that contain heat sensitive and cold sensitive neurons and are mainly responsible for the stimulation of these sweat glands.
Other drugs suggested for antidepressant-induced sweating include clonidine (Catapres), an alpha-adrenergic agonist, and beta-adrenergic blockers such as atenolol (Tenormin).
It should also be noted that approximately 80% of menopausal women experience sweating, along with the usual "hot flashes."
Sources:
1] Garber A, Gregory RJ: Benztropine in the treatment of venlafaxine-induced sweating (letter). Journal of Clinical Psychiatry 1997;58(4):176-177.
2] Feder R: Clonidine treatment of excessive sweating (letter). Journal of Clinical Psychiatry 1995;56(1):35.
Posted by shar on August 1, 2000, at 13:30:17
In reply to Extreme sweating when on SSRI's - may be this one?, posted by Sunnely on July 31, 2000, at 19:28:49
This topic was discussed in a previous archive, and someone said Wellbutrin caused excessive sweating also.
Ironically, I am on Effexor, Wellbutrin, and pre-menopausal to the extent that I have hot flashes causing sweating.
I have taken to wearing bandanas around my neck and forehead (to keep the sweat out of my eyes)when driving to an appointment. The other day I was downtown and saw the usual groups of (what looked like) gang kids, and I thought "What if my bandana is the wrong color and they think I'm hassling them on their turf?"
Then, "Surely nobody would kill a 48 year old lady in a red station wagon, with gray hair." But, ya never know. So, I just tried to look a little confused (no great stretch) like I had lost my way. Nobody bothered me.
Sigh,
Shar
Posted by Greg on August 1, 2000, at 14:49:29
In reply to Wellbutrin, Bandanas, and Gangs, posted by shar on August 1, 2000, at 13:30:17
> This topic was discussed in a previous archive, and someone said Wellbutrin caused excessive sweating also.
>
> Ironically, I am on Effexor, Wellbutrin, and pre-menopausal to the extent that I have hot flashes causing sweating.
>
> I have taken to wearing bandanas around my neck and forehead (to keep the sweat out of my eyes)when driving to an appointment. The other day I was downtown and saw the usual groups of (what looked like) gang kids, and I thought "What if my bandana is the wrong color and they think I'm hassling them on their turf?"
>
> Then, "Surely nobody would kill a 48 year old lady in a red station wagon, with gray hair." But, ya never know. So, I just tried to look a little confused (no great stretch) like I had lost my way. Nobody bothered me.
>
> Sigh,
> SharOr a 35 year old in a Red Corvette with red hair either.... ;^) tee hee
Posted by Steve2 on August 1, 2000, at 23:19:11
In reply to Re: Wellbutrin, Bandanas, and Gangs » shar, posted by Greg on August 1, 2000, at 14:49:29
Thanks everyone for your thoughts. I firmly believe that this is a side-effect that is not taken very seriously by the medical profession. I mean, I can tolerate a lot of side effects, but this is so embarrasing and frustrating it almost makes the taking of antidepressants seem counterintuitive.
Posted by CarolAnn on August 2, 2000, at 7:38:10
In reply to Wellbutrin, Bandanas, and Gangs, posted by shar on August 1, 2000, at 13:30:17
You are too funny!!
FYI when my mom went thru menopause, she swore by vitamin E for sweating and hot flashes, and she has never been the type for 'natural' remedies.
CarolAnn
Posted by CarolAnn on August 2, 2000, at 7:42:23
In reply to Re: Thanks for your imput, posted by Steve2 on August 1, 2000, at 23:19:11
Just posted this to Shar, and I don't know if it will help anyone, but when my mom went thru menopause she swore by Vitamin E for sweating and hot flashes, and she's never been big on 'natural' remedies. Might be worth a try for medication related sweating. Sorry I haven't posted this before now, I didn't think of it until Shar's post reminded me.
CarolAnn
Posted by Barbara Malm on August 2, 2000, at 18:04:31
In reply to extreme sweating when on SSRI's, posted by Steve2 on July 30, 2000, at 16:45:04
> Does this sound familiar to anyone: Whenever I'm on an SSRI or Effexor I have problems with extreme sweating. I'm not talking about a liitle persperation -- I'm taking streams of sweat and a general intolerance to the heat. So, does Seretonin cause elivated body temp? How?
I surely don't know how or why the SSRI's cause so much sweating but in addition to Celexa, I take Wellbutrin and Cytomel. You talk about sweating! I can't exercise in the daylight in the summer because of heat intolerance - I exercise at night - thank God I live in a safe neighborhood. What I regret the most is that I never have a good hair day anymore - and that is very depressing!
Posted by NikkiT2 on August 3, 2000, at 5:49:03
In reply to extreme sweating when on SSRI's, posted by Steve2 on July 30, 2000, at 16:45:04
I've always suffered from hyperhydrosis, and have tried a few different things to help combat it, but decided aginast surgery!!
Now, I'm on Effecor xr, imagine what I am like!! As a young lady, to be socked through by the timre I arrive to work is a nightmare... The Effexor has particularly caused my head (under my hair, very strange sensation whe it runs down through it) and neck to sweat intensly. I ahve rivers running down me when travelling to work espcecially - I have learnt to only wear clothing that doesn't show sweat (black in other words!!). The extra sweat is causing me problems now though.
Also, I soak through the sheets at night - I live int he UK where it isn't exactly warm most of the time, so others aren't sweating like me!! But, it's price to pay, and the effexor seems to be working, so I just ahve to weigh it up whether it's worth putting up with!!!
Nikki
Posted by cakes on August 3, 2000, at 9:45:45
In reply to Hyperhydrosis AND Effexor!!, posted by NikkiT2 on August 3, 2000, at 5:49:03
I'm on 75mg, and so far, I have only noticed extreme sweating at night. (Haven't noticed it during the day, but then again I live in Louisiana and it's August!)
Cakes
Posted by anita on August 4, 2000, at 13:13:20
In reply to Re: sweating tip..., posted by CarolAnn on August 2, 2000, at 7:42:23
For those of you who sweat mainly in the trunk area, I found Xerac AC Solution (prescription) on the body and Robinul (prescription anticholinergic) to work for me. Other anticholinergics _didn't_ work, so maybe Robinal is worth a try if you didn't respond to others.
anita
Posted by shar on August 5, 2000, at 1:15:12
In reply to Re: sweating tip..., posted by CarolAnn on August 2, 2000, at 7:42:23
I'm trying Vitamin E. Just started yesterday. Will let you all know how it's going; I certainly have lots of opportunities here to sweat...
Shar
This is the end of the thread.
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